HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � , '�)' �O I Permit Number:
RECEIVED
Building Permit Application DEC 21 2021
Planning and Development Services
St. Lucie County
Building and Code Regulation Division Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 'Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line,
PROPOSED IMPROVEMENT LOCATION
Address: 12063 S. INDIAN RIVER DR., JENSEN BEACH, FL 34957
Legal Description: FEE'S S/D LOT 6
Property Tax ID #: 4504-602-0006-000-9 Lot No.
Site Plan Name: Block No.
Project Name: FAUSTINO RESIDENCE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF. WORK!'
REMOVE EXISTING FIXED ROOF STRUCTURE AND REPLACE WITH CANOPY COVER.
PROPOSED CANOPY COVER NOT TO EXCEED EXISTING FIXED ROOF STRUCTURE LIMITS.
INSTALL 16K 4-POST BOATLI FT. (SPECS H EET ATTACHED). CA(I 0GL._T -rt) E�CCIgT►' t') l6
'CONSTRUCTION INFORMATION
Additional work to be rformed under
11HVAC Gas Tank
this permit -check
Gas Piping
all apply:
_Shutters
❑ Windows/Doors
Electric 0 Plumbing
[]Sprinklers
1:1 Generator
E]Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 26" 9cJC) • Utilities:�Sewer Septic
Building Height:
-OWNER/LESSEE:
CONTRACTOR: '
Name FAUSTINO FERNANDEZ
Name:
Address: 12063 S INDIAN RIVER DR.
Company:
T.
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. SO- - q 61 - ggLtJ-
o
Address: ,Vp, 6
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City: �VTsw:�.ewp
Zip Code: 'JL0ZL.2— Fax:
Phone No. 2-ZZ
E-Mail:
StateBn-
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so l)e
E-Mail: i ��' Z Qo U� rYl I l - Co lv1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
State:
Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structure , imming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TOO NE • Your failure to Record a Notice of Commencement may resu a ing twice for
improvements t your p perty. A Notice of Commencement must be re ed and posted o he jobsite__
ib fore the first i ection. If you intend to obtain financing, consult with r or an attorney 1?
c1mmencing wo or recording your Notice of Commencemen
re of Owner/Lessee/Contractor as Agent for Owner I Signature of
Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF ;e!6 l b(,ZG�� COUNTY OF ��yVN
The for oing instr ment was a knowledged before me
this day of 2Q;V by
(Name of person ackppwledging )
(Signature of Ndtary P�lic- State of Florida )
Personally Known iC�' OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
The f ing instrup;@n was acknowledged before me
this tp-- ay of 20 by
Personally Known 1 _ OR Produced Identification
Type of Identification Produced
N LAYFERNANDEZ Commission No.
MY COWSSION # GG314927
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